Download Abnormal Psychology

Unit 7
Abnormal Psychology
What are we studying?
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Abnormal Behavior
Classifying Psychological
Disorders
Anxiety and avoidance
Disorders
Affective Disorders
Schizophrenia
Dissociative Disorders
Personality Disorders
Treating Psychological
Disorders
Cognitive Therapies
Family Systems Theory
General Trends in
Psychotherapy
Community and Preventive
Approaches
Why study abnormal psychology?
Abnormal behaviour is part of our
common experience
 Lots of unanswered questions and
complexities
 Preparation for future careers
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◦ www.apa.org/students/
Abnormal Behavior
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Behavior that results
in:
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Stress
Pain
Impairs functioning
An increased risk of
death or loss of
freedom
Let individuals decide
for themselves
Abnormal Behavior
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Cultural Influences
Normal or abnormal
Abnormal based on time or place
Particular worldview
Middle Ages: Deviant behavior meant you were
possessed by demons,
Abnormal Behavior- Bio
Psychosocial Model
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Biological:
◦ Genetic Factors
◦ Neurotransmitter deficiency activities
◦ Hormonal abnormalities
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Further behavior can be affected by:
Brain damage, malnutrition, infectious
disease and drug overuse
Abnormal Behavior- Bio
Psychosocial Model
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Psychological:
◦ People’s reactions to events
◦ Reaction depends on the circumstances of the
event as well individuals own vulnerabilities to the
event
◦ A important component is: individuals past
history, or genetic predisposition relating to a
person’s reactions
Abnormal Behavior- Bio
Psychosocial Model
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Social:
◦ Cultural Perspective
◦ People are influenced both by how others act
towards them and by the expectations of others
Classifying Psychological
Disorders
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Diagnostic Statistics Manual (DSM) - A
list of accepted labels for psychological
diagnosis
◦ Currently in it’s 4th edition, revised (DSM-IV-Tr)
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5 Separate Axes
Diagnostic Statistics Manual DSM
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Current diagnostic system
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Axis I: Clinical, mental, and learning disorders
◦ Childhood Disorders (ADD)
◦ Stuttering
◦ Substance abuse,
◦ Eating disorders,
◦ Anxiety and mood disorders
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Sleep disorders
Impulse control disorders
Autism
Mental Retardation
Diagnostic Statistics Manual DSM
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Current diagnostic system
Axis II: Personality disorders and intellectual disabilities. Classifies those
disorders that last a lifetime:
◦ Personality disorders
◦ Impaired effectiveness in getting along with others
◦ Mental Retardation
◦ Narcissism
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Axis III: Evaluation of general medical conditions, as these can contribute
to overall mental functioning.
 Diabetes
 Cirrhosis of the liver
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Axis IV: Psychosocial and environmental problems, particularly stress.
Diagnostic Statistics Manual DSM
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Current diagnostic system
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Axis V: Global Assessment of Functioning
Score
Description
91-100
81-90
71-80
No Problems
Few or no symptoms
Temporary & expected
reactions to stressors
Mild symptoms,
maintaining relationships
61-70
Diagnostic Statistics Manual DSM
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Current diagnostic system
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Axis V: Global Assessment of Functioning
Score
Description
51-60
Moderate symptoms or
difficulty functioning
41-50
Serious symptoms or
impairment to functioning
31-40
Some impairment in reality
testing and communication or
serious impairment in
functioning
Diagnostic Statistics Manual DSM
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Current diagnostic system
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Axis V: Global Assessment of Functioning
Score
Description
21-30
Presence of hallucinations or
delusions which influence behavior
11-20
Some danger of harm to self or
others or occasional failure to
maintain hygiene, or incoherent/mute
1-10
Persistent danger to self or others
or inability to maintain hygiene or
has made a serious attempt at suicide
Anxiety and Avoidance Disorders
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According to DSM-IV Anxiety Disorders:
◦ Are lingering,
◦ Almost constantly present,
◦ Cause thoughts or environmental triggers to induce
psychological and physiological symptoms of distress
◦ Those who feel helpless to control major life events are
most prone to severe anxiety
Anxiety and Avoidance Disorders
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Examples of DSM-IV Anxiety Disorders:
◦ Panic Disorder (PD): 2% of all adults in US with
more woman than men. Panic attack causes one to
experience sudden expected anxiety at an almost
unbearable level. The person sweats, trembles, gasps for
air, experience dizziness and accelerating pulse rate.
 Perceive the world as unreal to themselves
 Sense of personalization
 Catastrophic thoughts, they feel out of control, may wind
up in the hospital , last several minutes but can consume
several hours.
◦ Social Phobia: Fear of anything public and avoidance of people
◦ Agoraphobia: An excessive fear of public areas
General Anxiety Disorders
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Generalized Anxiety Disorder (GAD): Excessive and
exaggerated anxiety
◦ Areas: Worry; include work, family, money and health
◦ Extreme pervasiveness of the worry is what labels the condition and
generalizes anxiety disorder
◦ Cognitive and physiological difficulties
◦ Difficulty with decision making
◦ Difficulty remembering commitments
◦ Individual experiences muscle tension, heightened arousal of the nervous
system
◦ Headaches, nervous twitches, indigestion and insomnia
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GAD is frequently accompanied by Depression
◦ Antidepressant drugs are an effective treatment providing immediate results
◦ Relaxation training provides more long lasting than drug therapy
Phobias (Phobic Disorder)
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Phobia: Characterized by intense fear of specific
object or situation that actually poses no threat to
the individual.
◦ Interferes with daily living,
◦ Confrontation may lead to sweating, trembling, rapid heart rate and
breathing
◦ Difference in phobic reactions are established based on severity
We are born with some fears however most are
learned and can be traced to a certain event.
 Therapeutic Phobia treatments include:
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 Flooding: Sudden exposure to the feared object
 Systematic Desensitization: Gradual, repeated exposure to the
feared object
 The most successful
Obsessive-Compulsive Disorder
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Obsessive-Compulsive Disorder aka “OCD”:
Characterized by repetitive obsessions and/or compulsions.
◦ Obsession: Repetitive thought that exists and continues to
invade an individuals conscious mind
◦ Compulsion: Repetitive action that an individual has no
conscious desire to repeat (an almost irresistible action)
 Obsessions continue even when an individual tries to repress them;
obsessions surround themes of violence, sex or contamination
◦ Two Common Compulsions
 Checking Rituals: Interruption of their daily activities continually checking
to make sure then performed what was required
 Cleaning Rituals: Involve an obsession with the idea of contamination, IN
the most severe form, obsessive-compulsive disorders can be completely
disabling
Obsessive-Compulsive Disorder
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Exposure Therapy: Normally perform a ritual however they are
prevented form performing it
Drug Therapy: Clomipramine (Anafranil) is helpful for about half of
obsessive- compulsive patients
Post-Traumatic Stress Disorder
 (PTSD): Acute
reactions to significantly
traumatic events
Include: War, Assault, Rape, Floods, Earthquakes, accidents
and fires.
Numbness to the world
Relive the trauma and experience anxiety
Symptoms appear shortly after the trauma
DSM-IV: acute or chronic?
Fear, helplessness or horror
Affective Disorders
 Affective
Disorders: Extreme moods and swings
 Normal functioning may experience an episode of despair or mania
 Major Depressive Disorder: One or more major depressive
episodes without a history of manic, hypomanic, or mixed episodes
 Depressed individuals often feel helpless and hopeless
 Suffer from loss of pleasure or interest in regular activities
 Disturbance in eating habits
 Sleep disturbance
 Loss of energy
 Feeling of worthlessness or guilt, difficulties in thinking, concentration,
and memory and recurrent thoughts of death and suicide.
 DSM-IV- Symptoms must persist most every day for at least two weeks
 Distress in social, occupational or areas important to functioning
Affective Disorders
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Dysthymia: A “flat affect” and inability to connect.
 Introverted
 Morose
 Over conscientious
 Low energy level
 Low self-esteem
 Suicidal Ideation
 Disturbances of Eating, Sleeping and Thinking
 Also associated with major depression
 Do not experience symptoms chronic enough for a diagnosis of major depression
 Heredity and family influences
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Adolescent boys and girls suffer from depression equally
After adolescence woman suffer from depression about twice as often as
men
Affective Disorders
 Depression
usually involves an unpleasant event
 It occurs most often among people with little or no
social support
 Seasonal Affective Disorder (SAD)
 Depression with seasonal pattern of the year
 Sleep and eat excessively during depressed time
 Fall asleep late and awaken late
 Get sleepy early and wake up early
 Depressive mood swing
 Elevated mood swing
Bipolar Disorder
Depressive as well as manic episodes
 Appear late in adolescence in the form of a manic episode
 Variety of patterns
 Initial manic episode may be followed by a normal period,
then a depressed period
 Bipolar disorder is much less common than major depression
 Women are twice as likely to be diagnosed with depression
 Bipolar disorder occurs in both sexes at the same frequency
 Bi-polar disorder is more prevalent among higher
socioeconomic groups
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Causes of Mood Disorders
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Biological disorders
Heredity
Neurobiological Abnormalities
Neurotransmitter
Deregulation
Hormones
Learned Helplessness: A response to prolonged stress over which the
individual has no control, where apathy and helplessness may lead to
depression and cognitive explanations
Sociocultural factors include interpersonal relationships, socioeconomic
and ethnic factors, cultural variations and gender
Treatments
Severe and debilitating
 Responds well to both psychotherapy and drug therapy
 Common Antidepressant drugs:
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 Tricyclics: Blocks reabsorption of neurotransmitters dopamine,
norepinephrine and serotonin. Side effects: dry mouth, heart
irregularities, difficulty urinating and drowsiness
 Selective Serotonin Reuptake inhibitors (SSRIs)—block reputake
of neurotransmitter Serotonin
 Fewer and milder side effects than Tricyclics that include nausea and
headaches. Ex: Zoloft, Luvox, and Paxil
 Monoamine Oxidase Inhibitors: Block metabolic breakdown of
released dopamine, norepinephrine and serotonin
Treatments
 Electro
conclusive Therapy (ECT): A brief
electrical shock administered across the
patients head to induce convulsion
ECT became poplar in 1940’s as a treatment for
schizophrenia and depression
More antidepressant drugs became more readily available,
ECT lost favor
Since 1970’s however ECT is being used for severely
depressed patients who fail to respond to drug therapy
Mood Disorders and Suicide
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Severely depressed people with bipolar disorder consider suicide and may
attempt it
Feelings of guilt or disgrace
Cult leader tells them that death is a route to salvation
Records are not always accurate; people sometimes disguise their suicide
to look like accidents
More than 13% of adults had considered suicide and more than 4% had
survived a suicide attempt
Differences in suicide rates as function of age, country and gender
Most men use a gun or other violent means
Woman try poison, drugs or other no-violent methods that are fatal
Warning signs are given in advance
Schizophrenia
 Positive
(Present) Symptoms
 Behaviors that are notable due to their presence and include:
 Hallucinations,
 Delusions
 Thought disorders
 Negative
(Absent) Symptoms:
Notable due to their absence, such as…
 Speech deficits,
 Lack of emotional expression
 Inability to care for one’s self
Schizophrenia
 Types
of Schizophrenia
Undifferentiated Schizophrenia: Deterioration of daily
functioning plus a combination of hallucinations, delusions,
inappropriate emotions and thought disorders
 Catatonic Schizophrenia: Prominent movement disorder;
either rigid inactivity or excessive activity
 Disorganized Schizophrenia: Incoherent speech, extreme
lack of social relationships, and odd behavior
 Paranoid Schizophrenia: Elaborate hallucinations and
delusions around feelings of persecution and delusions of
grandeur
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Causes of Schizophrenia
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Due to genetics
Predisposition toward schizophrenia
Neurodevelopment Hypothesis:
Abnormal brain development before or at
the time of birth due to difficult pregnancy,
mothers poor nourishment, small birth
weight or an Rh-negative mother with an
RH positive baby
Season of birth effect where people born in
the winter moths slightly more likely to
develop schizophrenia than people born at
other times
Therapies for Schizophrenia
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Antipsychotic Drugs
◦ Take effect gradually
◦ Have some unwelcome side affects
◦ Tardive Dyskinesia: Tremors and involuntary movements
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Types of Antipsychotic Drugs
◦ Chlorpromazine
◦ Throazine-1st Schizophrenic drug
◦ Haloperidol (Haldol)- helps to control schizophrenia and allow people to
leave mental hospitals
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Successful drug therapy
◦ Sudden relapses
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Family therapy
◦ Reduces hostile comments improves chance of recovery
Dissociative Disorders
Psychogenic Amnesia
 Psychogenic Fugue
 Dissociative Identity Disorder (DID)
 Depersonalization Disorder
 Derealization
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Dissociative Disorders
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In general, the concept of “mental
disorder” can be defined as:
◦ A biomedical, culturally independent, valuefree concept
◦ Or as a social, culturally relative, value-based
concept.
Dissociation
Is a splitting apart of normally integrated
components of personality
 Screening out of identity and memory
 Exists w/o recognized damage to the
brain
 A way of coping with psychological stress
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Amnesia
Forgetting past events and experiences
 Confusion and disorientation
 May result because of organic brain
damage not always
 A result of psychological stress
 Two Forms:
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◦ Retrograde Amnesia
◦ Anterograde Amnesia
Psychogenic Amnesia
Often appears suddenly after
psychological stress
 May suddenly disappear
 Forgotten and screened out
consciousness
 Hypnosis may help in recovering events
that are lost
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Psychogenic Fugue
Sudden, unexpected excursion, then the
individual forgets their true identity only
to assume a new identity
 Purposeful in their movements
 Occurs suddenly
 Individuals wake up experiencing
complete amnesia concerning events that
occurred
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Dissociate Identity Disorder
DID aka Multiple Personality Disorder
 Alienation between two distinct personalities
 Each personality exists as well-integrated and
developed
 Each has it’s own tastes, memories, learned
behaviors
 Many different patterns of personalities
 Increase in personalities leads to increase
complexity
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Depersonalization Disorder
Disruption in personal identity
 Disruption exists w/o amnesia
 Cut off from selves as if they are viewing
themselves from the outside
 Strangeness of self leads to strangeness of
the world
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Depersonalization Disorder
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Derealization: Episodes of…
◦ Déjà vu (already seen)
◦ Jamasis vu- (never seen)
◦ Familiar place of never having experienced the
location before
Hypochondriasis
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Preoccupation with fears of having, or the idea that
one has, a serious disease based on the person’s
misinterpretation of bodily symptoms
Somatization Disorder
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Formerly known as Briquet’s syndrome
Recent and numerous physical complaints
Can persist for several years and cause one to seek
medical help; no medical basis for complaints can
be found
Symptoms are explained in a vague and
exaggerated way
Several medical symptoms for a diagnosis
Conversion Disorder
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Actual impairment of motor and sensory function
Conversion Symptoms include: blindness, deafness
and paralysis
Sometimes mimic epilepsy or cancer
DSM-IV conversion disorder specifies deficit affect
is voluntary motor or sensory function
Paranoid Personality
Disorder
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Paranoid personality disorder is
characterized by a distrust of others
and a constant suspicion that people
around you have sinister motives.
Paranoid Personality Disorder
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They search for hidden meanings in
everything and read hostile intentions
into the actions of others.
•They are quick to challenge the loyalties of friends and
loved ones and often appear cold and distant to others.
They usually shift blame to others and tend to carry long
grudges.
Schizotypal Personality
Disorder
 Detachment
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from social relationships
 Odd thinking
 Neglect of normal grooming
 Restricted range of emotional
expression in interpersonal situations
 Difficult to get along with - often
have problems in close relationships
Antisocial Personality Disorder
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Antisocial personality disorder is
characterized by a lack of conscience
◦ People with this disorder are prone to criminal
behavior, believing that their victims are weak and
deserving of being taken advantage of
◦ They tend to lie and steal
◦ They are careless with money and take
action without thinking about consequences
◦ They are often aggressive and are much more
concerned with their own needs than the needs
of others
Borderline Personality Disorder
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Characterized by mood instability
and poor self-image
◦ People with this disorder are prone to
constant mood swings and bouts of anger.
◦ They will take their anger out on
themselves, causing themselves injury
◦ Suicidal threats and actions are not uncommon
◦ They are quick to anger when their
expectations are not met.
Narcissistic Personality Disorder
 Characterized
centeredness
by self-
◦ They exaggerate their achievements,
expecting others to recognize them as
being superior
◦ They tend to be choosy about picking
friends, since they believe that not just
anyone is worthy of being their friend
◦ They are generally uninterested in the
feelings of others and may take
advantage of them.
Histrionic Personality Disorder
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Pervasive, excessive emotionality and attention
seeking behavior
Exaggerated displays of manipulative emotion
Attracting attention and sympathy
Lively & dramatic
Draws attention to oneself
Charmin with new acquaintances
Enthusiasm and flirtatiousness
Qualities wear thin and demanding of center
stage continues
Dependent Personality Disorder
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Characterized by a pervasive
psychological dependence on other
people.
◦ Has difficulty making everyday
decisions without an excessive amount
of advice and reassurance from others
Obsessive Compulsive Personality
Disorder
Characterized by a general
psychological inflexibility, rigid
conformity to rules and procedures,
perfectionism, and excessive
orderliness.
 People with OCPD tend to stress
perfectionism above all else, and
feel anxious when they perceive
that things aren't "right".
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Treating Psychological Disorders
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Types of Therapy
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Psychotherapy
Psychoanalysis
Humanistic Therapies
Behavioral Therapies
Cognitive Therapies
Family System Therapy
General Trends in Psychotherapy
Community and Preventative Approaches
Treating Psychological Disorders
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Types of Therapy
◦ Psychotherapy
◦ Treatment of Psychological Disorders
◦ Relationship between mental health professional
and client
Treating Psychological Disorders
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Types of Therapy
◦ Psychoanalysis
◦ Psychodynamic: Uncovers and resolves peoples
underlying drive and motives
◦ Sigmund Freud's View: Underlying sexual motives
& unconscious thoughts
◦ Cathartic: Releasing pent up emotions associated
with dreams, unconscious thoughts and
memories
Treating Psychological Disorders
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Types of Therapy
◦ Psychoanalysis: Developed by Freud
◦ Free Association: Thinking about a specific
problem and reports everything that comes to
mind without omitting or censoring anything
◦ Dream Analysis: Latent content – A form of
wish fulfillment
 Wish remains hidden
Treating Psychological Disorders
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Types of Therapy
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Humanistic Therapies
Power surrounding peoples choices
Full potential
Insight therapy
Conscious and deliberate decision making abilities
to achieve
◦ Distress when people don’t like or criticize them
◦ Incongruence: Mismatch of self-concept and ideal
self
Treating Psychological Disorders
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Types of Therapy
◦ Resistance: Repression of material that gets in
the way of therapy
Treating Psychological Disorders
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Types of Therapy
◦ Person Centered Therapy
Carl Rogers
Best know version of humanistic therapy
Person centered
Non-directive
Therapists listens to the client sympathetically with acceptance
and unconditional positive regard
 Parent/Child Atmosphere freely explored, feelings conveyed to
client
 Constructively resolve their problems
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Treating Psychological Disorders
Types of Therapy
o Behavioral Therapies
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oBehavior is learned
oChange behavior rather than considering
underlying motives
oBegins with a clearly established behavioral goal
oSetting of goals helps evaluate therapies
effectiveness
Treating Psychological Disorders
 Types
of Therapy
◦ Aversion Therapy
 Punishment
 To teach dislike or aversion
 Ex: quit smoking – depleted oxygen
Treating Psychological Disorders
Types of Therapy
o Systematic desensitization
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oList of anxiety-evoking situations
oListing the most anxiety producing last
oDeep relaxation
oImaging of situation that arouse from least to
most
Treating Psychological Disorders
Types of Therapy
o Cognitive Therapies
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o Changing thought or beliefs
o RET
o Peoples emotions are dependent on their internal
cognition
o Rational Emotive: Thoughts that are rational and lead
to emotions
o Irrational beliefs and move toward contradiction
Treating Psychological Disorders
Types of Therapy
o Cognitive Behavior Therapy:
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oCombination of cognitive and behavioral
oEstablishment of explicit goals for changing
behaviors
oMore focus on interpretation of their particular
situation
Treating Psychological Disorders
Types of Therapy
o Family Systems Therapy
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oFamily with difficulties
oMarriage counseling
oPsychoanalysis
oBehavior therapy
oTalks with more than one family at a time
Treating Psychological Disorders
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o
Types of Therapy
Gestalt Psychology
o Ability to perceive overall patterns
o Not broken down into component
parts
o Visual perception is an active
creation
o Separate, figure and ground object is
separate from the background
o Proximity: Tendency perceive object
close together belonging to group
o Similarity: Objects resemble each
other
o Continuation: Lines are interrupted
Treating Psychological Disorders
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Community and Preventative Approaches
◦ Focus of the needs of large groups than those of individuals
◦ Primary Prevention: Target at-risk groups
◦ Secondary Prevention: Identification of disorder in early stages,
keeping it from becoming more serious
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Assistance Programs
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Ban Toxins: Lead based paint
Prenatal education
Job placement
Provide childcare
Improve educational opportunities